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Acute ST-Elevation Myocardial Infarction Complicating Infective Endocarditis: A Case Report and Review of Reported
Hatim Al Lawati1, Mohamed M Madan2, Ahmed Shams1
1Adult Cardiology, The National Heart Centre, The Royal Hospital, Muscat, OMN.
Insights
Acute myocardial infarction complicating infective endocarditis has high early mortality. This case highlights the poor outcomes of percutaneous coronary intervention in such severe cases, emphasizing the need for further research.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Medicine
Background:
- Acute myocardial infarction is a rare but serious complication of infective endocarditis.
- Valvular vegetations can embolize to coronary arteries, causing myocardial infarction.
- Outcomes following revascularization for this condition are poorly documented.
Abstract:
Acute myocardial infarction in the context of infective endocarditis is a dreadful complication. Various mechanisms have been proposed to explain this complication; embolization of fragments of valvular vegetations into the coronary tree is one possible mechanism. Early mortality with this complication is reportedly high. Moreover, outcomes after treatment, either with percutaneous or surgical intervention, are not well-described in the literature. We report a case of acute ST-elevation myocardial infarction complicating bacterial native aortic valve endocarditis. Despite aspiration of infective debris and stent implantation in the left anterior descending coronary artery, the patient died from cardiogenic and septic shock. We also summarize the literature reporting outcomes of such patients undergoing percutaneous coronary intervention and comparing them to the outcomes of patients undergoing surgical revascularization.
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